The role of interferon-alpha in the treatment of myeloproliferative disorders

The interferons are cytokines with a wide array of biological properties. I n hematological malignancies the most used TFN class is -alpha; it has been used for thirty years but the mode of action is still not absolutely clear . Nevertheless, the benefits of IFN-alpha for the treatment of CMD have bee n described in particular for CML and less for PV, ET and MMM. IFN-alpha is presently considered the golden Standard of therapy for CML pa tients not eligible for SCT; the antileukemic effect has been well document ed by hematological and cytogenetic response. The survival advantage for IF N treated patients is remarkable in comparison with patients treated with c onventional chemotherapy. Recently, the combination IFN-alpha plus Ara-C ha s demonstrated to increase the rate of major cytogenetic response and to pr olong survival. To date, there is not a generally accepted treatment for ET, PV and MMM, wh ich can reduce the risk of thromboembolism and/or hemorragic events. In sev eral subsets of ET and PV patients, IFN-alpha can be considered as first li ne therapy. IFN-alpha is usually associated with the development of early and later sid e effects, that reduce the enthusiasm for its use. In the future PEG-IFN-al pha would improve the quality of life of IFN-treated CMD patients.